口腔医学研究

口腔医学研究 ›› 2024, Vol. 40 ›› Issue (10): 878-884.DOI: 10.13701/j.cnki.kqyxyj.2024.10.006

• 口腔颌面外科学研究 • 上一篇    下一篇

196例颈深部感染患者临床特征分析:一项多中心15年回顾性研究

马英娟1, 李晨曦2,3*, 王玥4, 龚忠诚2*   

  1. 1.新疆医科大学第一附属医院急诊创伤外科 新疆 乌鲁木齐 830054;
    2.新疆医科大学第一附属医院(附属口腔医院)口腔颌面肿瘤外科,新疆维吾尔自治区口腔医学研究所 新疆 乌鲁木齐 830054;
    3.新疆医科大学临床医学博士后科研流动站 新疆 乌鲁木齐 830054;
    4.新疆维吾尔自治区人民医院颌面外科 新疆 乌鲁木齐 830001
  • 收稿日期:2024-08-21 出版日期:2024-10-28 发布日期:2024-10-24
  • 通讯作者: *李晨曦,E-mail:lichenximed@163.com;龚忠诚,E-mail:gzc740904@xjmu.edu.cn
  • 作者简介:马英娟(1989~),女,新疆人,本科,助教,护师,研究方向:头颈部急危重症。
  • 基金资助:
    口腔颌面发育与再生湖北省重点实验室开放课题基金(编号:2022kqhm008)

Clinical Characteristics Analysis of 196 Patients with Deep Neck Infection: A Multicenter Retrospective Study Over 15 Years

MA Yingjuan1, LI Chenxi2,3*, WANG Yue4, GONG Zhongcheng2*   

  1. 1. Department of Emergency and Traumatic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;
    2. Department of Oral and Maxillofacial Oncology & Surgery, School/Hospital of Stomatology, the First Affiliated Hospital of Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi 830054, China;
    3. Clinical Medicine Postdoctoral Scientific Research Station, Xinjiang Medical University, Urumqi 830054, China;
    4. Department of Maxillofacial Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
  • Received:2024-08-21 Online:2024-10-28 Published:2024-10-24

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摘要： 目的: 调查评估颈深部感染(deep neck infection,DNI)患者影响预后的危险因素。方法: 回顾性分析新疆地区2010年1月~2024年8月因DNI住院治疗的196例患者的临床资料。除评价患者人口学特征外,还通过单因素及多因素Logistic回归分析确定影响严重并发症及长期住院的DNI患者预后的独立危险因子。结果: 多因素Logistic回归分析结果显示存在合并症(P1=0.013,P2<0.001)、中性粒细胞与淋巴细胞比率(neutrophil-to-lymphocyte ratio,NLR)(P1=0.005,P2=0.008)分别是患严重并发症及长期住院的DNI患者的独立危险因子。存在合并症对DNI患者发生严重并发症且长期住院的诊断价值较好,受试者工作特征曲线下面积(area under curve,AUC)分别为:AUC合并症=0.77及AUC合并症=0.82。NLR值也显示了较好的评价效能,分别为AUCNLR=0.81及AUCNLR=0.82。另外,白细胞计数(white blood cell counts,WBC)诊断预测严重并发症的AUCWBC=0.90;不同感染来源、C反应蛋白(C-reactive protein,CRP)及降钙素原(procalcitonin,PCT)水平预测患者长期住院(>10 d)的AUC值分别为0.69、0.73、0.71。结论: 本研究发现存在合并症、不同感染来源、WBC、NLR、CRP及PCT为预测DNI患者发生严重并发症且长期住院的危险因素。

关键词: 颈深部感染, Logistic回归分析, 负压封闭引流, 预后因素

Abstract: Objective: To investigate the risk factors on prognostic survival of patients with deep neck infection (DNI). Methods: Clinical materials from 196 patients that were admitted to the two principal hospitals in Xinjiang Uygur Autonomous Region between January 2010 and August 2024 due to DNIs were retrospectively analyzed. In addition to assessing patient’s demographic characteristics, the independent risk factors that could predict clinical prognosis for patients due to serious complications and long-term hospitalization were identified by performing analyses of the univariate and multivariate logistic regression model. Results: According to multivariate logistic regression analyses, the presence of comorbidities (P1=0.013,P2<0.001) and neutrophil-to-lymphocyte ratio (NLR) (P1=0.005,P2=0.008) were independent risk factors for severe complications and long-term hospitalization in patients with DNI. The presence of comorbidities had good diagnostic value for severe complications and long-term hospitalization in DNI patients, with area under curve (AUC) of 0.77 and 0.82, respectively. The NLR level also showed good evaluating performance, with AUC=0.81 and AUC=0.82, respectively. In addition, the AUC value for diagnosing severe complications based on white blood cell count (WBC) was 0.90; other AUC values for predicting long-term hospitalization (>10 days) of patients based on different origin of infection, C-reactive protein (CRP), and procalcitonin (PCT) levels were 0.69, 0.73, and 0.71, respectively. Conclusion: This present study found that the combination of variables for both complications and long-term hospitalization are promising for prognostic purposes.

Key words: deep neck infection, Logistic regression analysis, vacuum sealing drainage, prognostic variable